How to Reverse the Organ Shortage

Thousands of lives are lost each year because of a lack of organs available for transplant, but currently, in the UK and many other countries, organs cannot be taken from a deceased donor without explicit consent from the donor or his or her relatives. Switching to an 'opt-out' (or 'presumed consent') system for organ donation could substantially increase the supply of organs, and save many lives. However, it has been argued in some quarters that there are serious ethical objections to an opt-out policy, and that it would be better to adopt a different policy known as the 'presumptive approach', that requires explicit consent while also attempting to sway the choices of potential donors and family in the direction of donating, using various persuasive techniques. This article shows how reflection on the impact of a well-known cognitive bias known as 'status quo bias' can explain (i) why moving from the status quo to an opt-out policy might be effective in increasing organ availability, even without impinging on anyone's autonomous choices, (ii) why we might have overestimated the strength of the objections to an opt-out policy, and (iii) why the presumptive approach is morally objectionable, while an opt-out policy is not. © Society for Applied Philosophy, 2012